Individual
JOANNA SEWALL MANUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA055963
PA
363AS0400X
Surgical Physician Assistant
6742502-1206
UT
363AS0400X
Surgical Physician Assistant
Primary
PA2388
ME
Other
Enumeration date
01/28/2013
Last updated
09/08/2023
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